<%@ page language="java" contentType="text/html; charset=utf-8"
	pageEncoding="utf-8" isELIgnored="false"%>

<%
	request.setAttribute("title","理赔详情");
    request.setAttribute("modelConfigPath", "claim");
%>

<%@ include file="/WEB-INF/views/shared/master/contentHeader.jsp"%>
<style type="text/css">
   .content{
     margin-bottom: 28px;
  }
</style>

<t:panel cssClass="panel-flat form-detailed" customBody="true" customHead="true">
    <div class="detailed-navbar-content panel-body content">
        <t:form commandName="claimApplyfor" action="/admin/claim/claimApplyfor/save" method="post" cssClass="form-horizontal">
            <div class="hide">
                <t:hidden path="id"/>
                <t:hidden path="deleteMark"/>
                <t:hidden path="aid"/>
                <t:hidden path="customerId"/>
            </div>
            <t:formgroup>
                <t:label path="sex" cssClass="col-sm-2" />
                <t:selectButton path="sex" colClass="col-sm-4" />
                <t:label path="name" cssClass="col-sm-2" />
                <t:input path="name" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="product" cssClass="col-sm-2" />
                <t:input path="product" colClass="col-sm-4" />
                
            </t:formgroup>
            <t:formgroup>
                <t:label path="phone" cssClass="col-sm-2" />
                <t:input path="phone" colClass="col-sm-4" />
                <t:label path="orderNum" cssClass="col-sm-2" />
                <t:input path="orderNum" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="state" cssClass="col-sm-2" />
                <t:select2 path="state" colClass="col-sm-4" />
                <t:label path="trackPeopleName" cssClass="col-sm-2" />
                <t:input path="trackPeopleName" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="trackState" cssClass="col-sm-2" />
                <t:select2 path="trackState" colClass="col-sm-4" />
            </t:formgroup>
            <t:formgroup>
                <t:label path="comments" cssClass="col-sm-2" />
                <t:input path="comments" colClass="col-sm-10" />
            </t:formgroup>
        </t:form>
    </div>
    <div class="navbar-fixed-bottom">
    <t:panelFoot headingBtnCssClass="heading-btn pull-right-important">
		<t:button icon="icon-floppy-disk" onclick="saveData()" cssClass="btn-info" csize="sm">保存</t:button>
	</t:panelFoot>
	</div>
</t:panel>

<script type="text/javascript">
	function saveData(){
		if (!$("form:first").valid()){
			return;
		}
		$("form:first").submit();
	}	
</script>
<%@ include file="/WEB-INF/views/shared/base/scripts/jqueryui.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formselects.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formstyling.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formselects.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formpickers.jsp"%>
<%@ include file="/WEB-INF/views/shared/master/dialog.jsp"%>
<%@ include file="/WEB-INF/views/shared/master/contentFooter.jsp"%>
